<%= form_for @request_and_complaint_registration_request , :html => { :multipart => true } do |f| %>
  <% if @request_and_complaint_registration_request.errors.any? %>
    <div id="error_explanation">
      <h2><%= pluralize(@request_and_complaint_registration_request.errors.count, "error") %> prohibited this request_and_complaint_registration_request from being saved:</h2>

      <ul>
      <% @request_and_complaint_registration_request.errors.full_messages.each do |msg| %>
        <li><%= msg %></li>
      <% end %>
      </ul>
    </div>
  <% end %>

 <fieldset id="agrupacion" >
    <legend>Datos de Usuario </legend>
    
     <fieldset class="column-left" >
          <div class="field">
         <label>Nombre (*)</label><br />
          <%= f.text_field :name %>
         </div>

         <div class="field">
          <label>DNI (*)</label><br />
          <%= f.text_field :dni %>
        </div>
    </fieldset>
      <fieldset class="column-right" >

            <div class="field">
            <label>Mail (*)</label><br />
             <%= f.text_field :mail %>
            </div>
            <div class="field">
             <label>Telefono</label><br />
              <%= f.text_field :phone %>
            </div>

       </fieldset>
   </fieldset>

 <fieldset id="agrupacion" >
    <legend>Datos de Inscripcion </legend>

    <fieldset class="column-left" >
              <div class="field">
  
             <label>Descripción (*)</label><br />
              <%= f.text_area :description %>
            </div>

                <div class="field">
               <label>Imagen</label><br />
                <%= f.file_field :avatar %>
              </div>
            <div class="field">
              <p><label>Departamento (*)</label><br /><%= f.select :department,@departments.collect { |t| [t.name,t.id]}, {:include_blank=>"Seleccione"} %> </p>
            </div>

     </fieldset>
    <fieldset class="column-right" >
            

            <div id="provinces">
              <%= render :partial=>"provinces" %>
            </div>

            <div class="field">
              <label>Dirección (*)</label><br />
              <%= f.text_field :address %>
            </div>
    </fieldset>
    </fieldset>
 

  <div class="actions">
    <%= f.submit "Enviar", :class=> 'button',  :onclick => "return confirm('¿Está seguro que desea grabar?' )" %>
  </div>
<% end %>
